Does VEPTR meet the expectations?

Early onset scoliosis with associated thoracic deformities is a difficult treatment problem. In many cases early surgery is necessary with the use of such techniques to correction of spine and chest which would ensure their continued growth. One solution is a VEPTR system (vertical expandable titanium rib) designed for mechanical stabilization of the chest and spine. Aim of this study is to provide the effectiveness of surgical treatment of the spine and chest deformities using the system VEPTR during the early childhood. The authors describe their own experiences highlighting the difficulties associated with this method. Material and methods. In the Department of Pediatric Orthopedics, Medical University of Lublin staged surgery with VEPTR system was used in 12 children aged from 3 to 8 years. Three children required treatment because of multiple congenital spine deformations, four because of the neuromuscular scoliosis and five because of the kyphotic deformation in myelomeningocele. The number of surgical procedures in one child ranged from 3 to 8. Follow up from 10 months to 4 years. The observed failure and complications include: broken ribs (four times), perforation of the iliac by iliac hook (5 times), pneumothorax (2 times), re-adhesion of ribs (2 times), implant fracture (one time). Results and conclusions. Our own experience and the literature data underline the clinical efficacy of VEPTR. This method is only a temporary solution, but it appears to be an effective method in treating chest and spine deformation in the youngest children. The specificity of the method makes that the application of it reckon with the various difficulties and complications that may occasionally affect the final outcome. They are associated with the specific surgical technique and the implants construction. These threats do not disqualify the method, but that treatment must be carried out in specialized centers by a properly trained team.